1. SIX BASIC PRINCIPLES OF MEDICAL ETHICS
Theme: “Social Contract in Health Care”
SIX BASIC PRINCIPLES OF
MEDICAL ETHICS By
Brig[R]. Abrar Hussain Zaidi
Consultant Surgeon
HITEC-IMS - Taxila

2. Innate Human Desire To see the doctors
as the most trusted and respected
persons in the society

3. Trust is indeed withering due to declination and deviation
Doctors world over are still ;
Regarded very highly & trusted upon
[shown by polls]
But
Trust is indeed withering
due to declination and deviation
from basic Medical Ethics

4. TO DISCUSS MEDICAL ETHICS
A MORAL OBLIGATION
TO DISCUSS MEDICAL ETHICS
Responsibility of every teaching physician
to train the budding physicians.
Not only in the art of medicine,
but also in handling
the ethical dilemmas of medical practice.
[Hadith]

5. about human activities determine the acceptable human conduct
ETHICS
Discipline of addressing and evaluating
the social concerns
about human activities
that
determine the acceptable human conduct

6. Social Concerns & How should we conduct ourselves in society
ETHICS
Social Concerns
Normal Acceptable vs Abnormal Unacceptable
&
How should we conduct ourselves in society

7. -Individual to community -Community to community
CONCERNS MAY BE ;
-Individual to individual
-Individual to community
-Community to community
e.g.
Marriage and families,
Business,
Neighborhood,
Prisoners, wars,
Medical practice.

8. all over the world. Regional & geographic differences may exist. But,
the basic human norms & values are same
all over the world.

9. MEDICAL ETHICS Discipline that: A- Guides The Doctors;
Relationships: Patients, Colleagues, Society
Decision-making : in Patient Care
B-Defines and Evaluates;
Social Concerns In Medical Practice
Benefits & Risks To Human Life
Conduct Of Health Professionals
Standards Of Behavior Of Professionals
C- Make The Basis For Laws - Pertaining To
Health Care

10. How to determine
what is ethical and what is not?

11. Criteria
The Fundamentals/Principles of Medical Ethics

12. Principles/Criteria Make The Basis For
Guidance – Ethical/Acceptable practices
Evaluation- Social conduct of health professionals
Making laws-Basis of modern legal practice
Guidance : individual & institutional

13. EVOLUTION OF MEDICAL ETHICS
Medical ethics have evolved over centuries
Greek th century BC
Chinese ---2nd century BC.
Indian
Roman
Islamic Code Of Medical Ethics
Modern Era

14. 4th century BC.
The Greek physician Hippocrates
The Hippocratic Oath
Eight Paragraphs
Swearing The Oath:
Pledge to;
“Keep the patients from harm and injustice.”
“Give support to fellow physicians.”

15. 10th century
Adab al- Tabib (Ethics of a Physician)
most extensive works on ethics by
Ishaq ibn Ali Ruhawi
Christian who embraced Islam.
English translation by
American Philosophical Society, Philadelphia
Basis of modern day description
of principles of Medical Ethics

16. EVOLUTION OF MEDICAL ETHICS The Present Era
Regional /Country Regulating Bodies
AMA
NHS
PMDC [ Pakistan]
WHO
WMA
1847 Code of Medical Ethics.

17. EVOLUTION OF MEDICAL ETHICS THE PRESENT ERA
World Medical Association
Description of “Standards of conduct”
Oct 1948 –The Second General Assembly
Oath of Geneva [IF WE REMEMBER]
The Declaration of Helsinki
Human Experimentation/Research

18. SIX OF THE PRINCIPLES OF MEIDCAL ETHICS
1-Beneficence Act In The Best Interest Of Humanity.
2-Non-maleficence Do No Harm
3-Autonomy Patient’s Right To Refuse Or Choose [Consent]
4-Justice Treatment On The Merit Of Illness
5-Dignity Patient And Doctor Both To Be Respected
6-Confidentiality The ’ Trust’ / Not be Shared against the will
The criteria: that make the foundation of our OATH AND
on the basis of which Various bodies have developed the declarations and guidelines for their regional practices
That guide in making the laws governing medical practice
Some Basic principles that have evolved over centuries

19. Foundation of; Doctors oath Social conduct of doctors
Present days legal medicine
Van Guards of Care : Sentinel Projects and Beacons
When we talk about the van Guards of care = then what's guides what’s right and what’s wrong
These basic “Principles are the Beacons” that the individual stand on guard take the light from
Weather you just Evaluate an individual Social Conduct in the professional environment,
Evaluation of a Socio-Medical scenario
OR you Make a law

20. the benefit of the patient.
Ethical principles are primarily
patient centered,
for
the benefit of the patient.

21. SOCIO MEDICAL SITUATIONS
Reception / Communication
Medical examination
Wards
Theatres
Treatment options
Consent
Ventilatory support
Cost
Legal issues/courts
Research
Family planning
Abortion
Blood transfusion
Organ Donations & transplant

22. 1-2-BENEFICENCE & NON-MALEFICENCE
Do only what is good
and
bring no harm.

23. 1-2-BENEFICENCE & NON-MALEFICENCE
Patient’s wellbeing
Mental
Physical
Social
Material

24. 1-2-BENEFICENCE & NON-MALEFICENCE
a-Think good The intention
b-Talk /say good----The words
c-Do good The acts
&
d- Do no bad
Mental/Physical/Social/Material

25. [the first step in the right direction]
1-2-BENEFICENCE & NON-MALEFICENCE
a- Think good
Al Aamal O Bin Niiat
[the first step in the right direction]
May Allah help me in doing all good and
bring no harm to anyone by:
My Thoughts
My Words
My Acts

26. Expression - Representative of your thoughts Others can read your;
1-2-BENEFICENCE & NON-MALEFICENCE
a- Think good
Al Aamal O Bin Niiat
Expression - Representative of your thoughts
Others can read your;
Face
Accent
Body language/Gestures
You are silent, you may still be heard.
Your mind can be well read.

27. The Art of Communication patient doctor relationship
1-2-BENEFICENCE & NON-MALEFICENCE
b-Talk / say good
The Words
The Art of Communication
The foundation of
patient doctor relationship

28. 1-2-BENEFICENCE & NON-MALEFICENCE
b-Talk / Say good
The Words
The Art of Communication [the words]
Al-Quran
A- Talk to the people in the most pleasant way
B- Whatever you say, say good
C- Don’t say anything except what is good

29. 1-2-BENEFICENCE & NON-MALEFICENCE C-Do good -The Acts
Education and Professional Excellence [CME]
Dedication / Devotion
Primarily Aim at—Patient’s wellbeing
[not the material gains]
“A person who practices art of healing
when he is not acquainted with medicine,
will be responsible for his actions.”
[Hadith]

30. * Patients, first and foremost * Society * Other health professionals
As a member of medical profession,
we must recognize responsibility
towards;
* Patients, first and foremost
* Society
* Other health professionals
* Self

31. PRINCIPLES OF MEDICAL ETHICS
Conclusion
Section 7
PRINCIPLES OF MEDICAL ETHICS
Judicial Council American Medical Association
In the practice of medicine, a physician should limit the source of his professional income to medical services actually rendered by him, or under his supervision, to his patients. His fee should be commensurate with the services rendered and the patient’s ability to pay.
He should neither pay, nor receive a commission for referral of patients. Drugs, remedies or appliances may be dispensed or supplied by the physician, provided it is in the best interests of the patient

32. Conclusion People world over still wish to see
An Innate Desire
People world over still wish to see
the doctors as trustworthy and honorable.

33. We Can keep this trust.
Wish for others what you wish for yourself.
[Hadith]
How would “I” like to see a doctor
If I ever become a patient myself?

34. The Very Basic Of Our Code Of Conduct ?
Are we following
The Very Basic Of Our Code Of Conduct ?
Let Us Memorize Again
I LEAVE THE QUESTION

35. SIX OF THE PRINCIPLES OF MEIDCAL ETHICS
1-Beneficence Act In The Best Interest Of Humanity.
2-Non-maleficence Do No Harm
3-Autonomy Patient’s Right To Refuse Or Choose [Consent]
4-Justice Treatment On The Merit Of Illness
5-Dignity Patient And Doctor Both To Be Respected
6-Confidentiality The ’ Trust’ / Not be Shared against the will
The criteria: that make the foundation of our OATH AND
on the basis of which Various bodies have developed the declarations and guidelines for their regional practices
That guide in making the laws governing medical practice
Some Basic principles that have evolved over centuries

36. Thank you Hippocrates statue, Parnassus Ave.
in front of the Robert H. Crede Ambulatory Care Center of UCSF
Thank you

37. References and Bibliography
PRINCIPLES OF MEDICAL ETHICS Judicial Council American Medical Association
June 7, 1958 [ PDF ][online]
Medical Ethics Manual. World Medical Association 3rd edition 2015[PDF][AVAILABLE ONLINE] at
John R. WILLIAMS Ethics at the World Medical Association: From policy to practice
JMAJ 51(4): 290–293, 2008 [ONLINE] [PDF]
Sharif Kaf AL-Ghazal. Medical Ethics in Islamic history at a glance.
JISHIM 2004,3 [pdf]
Mustafa Y. Islam and the four principles of medical ethics. J Med Ethics Jul;40(7):479-83
Sahin Aksoy,Ali TenikThe 'four principles of bioethics' as found in 13th century Muslim scholar Mawlana's teachings
BMC Medical Ethics20023:4 DOI: /
Medical ethics in peacetime and wartime: the case for a better Understanding. International Review of the Red Cross (2013), 95 (889), 189–213.Violence against health care [ONLINE][PDF] doi: /S [AVAILABLE ONLINE] At:
Principles for Professional Ethics. National Association of School Psychologists 2010[ PDF] [ONLINE]
Codes of ethics and declarations relevant to the health Professions Fifth edition .2009
Amnesty International Ltd Peter Benenson House 1 Easton Street London WC1X 0DW United Kingdom
The Cambridge textbook of bioethics, edited by P.A. Singer and A.M. Viens (Cambridge U Press, 2008)
PRINCIPLES OF MEDICAL ETHICS Judicial Council American Medical Association
June 7, 1958 [ PDF ][online]
Section 7
In the practice of medicine a physician should limit the source of his professional income to medical services actually rendered by him, or under his supervision, to his patients. His fee should be commensurate with the services rendered and the patient’s ability to pay. He should neither pay nor receive a commission for referral of patients. Drugs, remedies or appliances may be dispensed or supplied by the physician provided it is in the best interests of the patient
Sharif Kaf AL-Ghazal. Medical Ethics in islamic history at aglance.
JISHIM 2004,3 [pdf] [online]